View Full Version : Abilify still causing akathisia (medical term for inner restlessness)


netsavy006
02-20-09, 05:50 PM
I am still having akathisia (http://en.wikipedia.org/wiki/Akathisia) from the Abilify. My dosage was recently reduced from 12.5mg to 5mg. I know it's going to take time for the higher dose to clear out of my system, but here's the deal. Even on 1mg of Abilify (taking the 2mg and splitting them), I was still having the akathisia. I really want to get off of the Abilify and remain on my prescious Zyprexa Zydis 5mg. I least I don't get akathisia on Zyprexa Zydis. I don't have an appt until March 3rd but I don't think I could last that long. She won't be back in her office till at least Monday. What should I do to at least last till Monday? What should I do/say on Monday when I call in to my doctor? I really just want off of this stuff, not a reduction in dosage...

Thanks in advance,
Andy...

Scarletta
02-20-09, 05:56 PM
I'd just quit taking it. Abilify has an EXTREMELY long half-life, about 75 hours. Considering it takes 10-12 half-lives to completely eliminate the drug, that's several days.

So as long as you get into your dr early next week you should be fine, you can start it up again if need be without probably noticing.

But I've had that akathisia when I was on 15 mg a day. It was HORRIBLE- I could not live like that. I could not sit down for 2 seconds. Just horrid restlessness. Once I cut back to 5 mg, I didn't have that anymore.

But it does interfere with Adderall since it can block dopamine receptors, so I decided I didn't want to take it anymore. Didn't feel the need for it with my other meds. So I no longer take it.

netsavy006
02-20-09, 06:21 PM
I would stop the Abilify first but I have to wait for my pdoc's permission. I really want to be off of it because of the akathisia, but I don't want to go against what the doctor says either. I'll see what happens over the weekend. I just don't know what to say on Monday when I call again if I'm still suffering the severe akathsia I have now. I'm on 2 medications to help for the restlessness and they aren't helping (Artane 2mg TID + Valium 5mg TID). I do have an anxiey history so I know I can't "play" with the Valium but I don't get the akathisia on Zyprexa Zydis, so if I was off of Abilify and just on the Zyprexa Zydis, I wouldn't need the Artane. It just get's very complicated because I just got things changed around at my last appt. 2/17. Then I called her 2/19 and she made changes again. I know I function better on Zyprexa Zydis than I do on this "silly" Abilify. I just want of as soon as I know I can. How should I explain my current problem(s) to the pdoc?

hannielaggie
02-20-09, 06:25 PM
I'm on Abilify as well. I feel that way all day long. I had an appt with my nurse practioner and she suggested that I just lower the dosage. I have my pdoc appt on the 3rd as well and I'm going to suggest what she suggested. The other option for me if my restlessness does not subside would be Geodon, another atypical psychotic. I feel that won't make a change if I were to lower it either. However, discontinuing it on your own is not a good idea because you're not aware of the withdrawal effects. A few days won't hurt you. Just be patient and I'm sure your pdoc will have some solution for you.

Good Luck.

netsavy006
02-20-09, 06:34 PM
Thanks hannielaggie. I hope my pdoc can come up with a good plan too. What my plan is: continue Abilify @ 5mg over the weekend. If it doesn't subside, I'll call my doctor on Monday, and see what she suggests I do. I'll tell her in my opinion, since I'm on a lower dose @ this point, I'd like to discontinue the medicaiton and see what she says. I'll let her know I'd be still having the restlessness/akathsia. I know what it's like. It's bad and there's not much out there to help control it. (My pdoc says there's only Cogentin and Artane). I've tried both medicines and they don't work for me.

I just hope my doctor tells me on Monday I can quit the Abilify so that I can slowly get back to stability with Zyprexa Zydis and slowly reduce the akathsia feeling, because I know the longer I take it, the longer the akathisia is going to last...

Scarletta
02-20-09, 07:47 PM
The only reason I cut my dose from 15 mg to 5 mg without my doctor's prior approval is that I was totally crawling out of my skin, I mean, I was at this two-day conference for work, and every 5 minutes I had to get up and walk out of the presentations. I could not sit still without this agonizing restlessness. I also attended a funeral at that time and had to leave after about 10 minutes. I couldn't sleep or rest and nothing gave me relief. I was on Lexapro and Klonopin at the time too but they did not offset the akathisia.

A few weeks later I had my dr's appt and I just told him that I had to cut it back because i could not stand it or live that way, and he just told me that was fine, to continue with the 5 mg if I wanted to because that didn't give me problems. Eventually I dropped it altogether.

It's just my opinion but I don't think you should have to go through 3 or so days of agony before seeing your doctor. I would stop it now and just leave a message with their service that you are stopping it because you can no longer take it, and you'll discuss it with her next week.

If the doctor knew you were feeling this bad they would not advise you to ride it out. Abilify is a very potent antipsychotic, and in larger doses typically does cause akithisia. There also is no withdrawal symptoms mainly because it has such a huge half life. You'd practically only have to take one dose a week and you'd be covered.

But do what you think is best!

netsavy006
02-20-09, 08:39 PM
That would be helpful but because of my past episodes where I wanted to overdose on my medication, I have Mom handling my medications. I've discussed with her about taking me off of the Abilify and she told me that I have to follow what the doctor is telling me to do because I have to get off the medication gradually and that maybe at my next appt. (3/3), I may be able to get off of it completely. But I don't know if I can hold on for that long. As you know akathisia is not pleseant and it's not pretty. Not only do I get akahtisia from Abilify, but it also increases my anxiety levels. I'm thankful that I was able to get my pdoc to get me back on Zyprexa Zydis 5mg, because usually she doesn't like it when I "play doctor" and "treat myself". But I understand where you are coming from. I really would like to discontinue the Abilify as soon as I can. That's why I plan to make the phone call on Monday to my doctor and hope to get the Abilify discontinued at that point...

Scarletta
02-20-09, 09:57 PM
How old are you that your mom controls your meds? If you're an adult, you have the right to decide what medication to take, not your mom, not your doctor even. And your mom is wrong that Abilify needs to be tapered off gradually. It does not, there is not a withdrawal syndrome. It can be stopped immediately.

If I were you, if you're an adult, and you really are in agony, I would just pretend to take the med if your mom is going to freak out about it.

Of course if you're underage then she does have the right to make you take it, I suppose.

And I'm not saying you should do one thing or another. It's your choice. I'm just saying I know the extreme horrible feeling of akathisia, and I had to do what i had to do, or else I would've gone crazy!

netsavy006
02-21-09, 12:58 PM
I know I'm an adult but I've had numerous hospitalizations all because I wanted to overdose on my medications. Because of this, Mom hides my medications and puts only the ones out that I need for the times I need them (similar to being in the hospital) because if she didn't, and if I had an episode, I could end up taking the whole bottle of pills. I feel comfortable with her handling my meds. I'm 21 by the way. I turn 22 on May 20.

It's just hard because I've been letting Mom know everyday that I can't handle the akathisia anymore and she tells me to stop and relax a bit but I know it's very difficult. She tells me that maybe the doctor will get me off of Abilify when I next see her on March 3rd, but I know that's to long to wait. I think Mom wants to see what happens after the extra Abilify gets out of my system (because I was on 15 and then went down to 12.5 and now I'm at 5mg).

I just called my pdoc on Thursday and had it reduced to 5mg. I know it takes time for the medicine to get out of the system (especially Abilify) because of the long half life.

What I don't know is what do I say to my pdoc on Monday so that I don't make things worse and so that she might get me off of Abilify and not say something like well take 2mg or split the 5's in 1/2 or something like that?

I could try to pretend to take the med tomorrow and Monday but where would I put it after, and I know she would notice if I was pretending to take the pill. I'm sure you know how moms are.

I understand I keep going in circles and I appoligise for that but I really don't know how I'm suppose to make myself last till Monday and what to say on Monday so that I can finally get off of this for good. Every time I end up on this medication, I get the same side effect...

Scarletta
02-21-09, 01:06 PM
On Monday just tell her you want to, and are going to, quit Abilify. THe doctors cannot force you to be medicated against your will. Tell her you want to try something else if needed, and she can decide what your next options could be.

But don't be afraid of the doctor. They are not gods. They can't force you to be medicated. As long as you are an adult and are competent and have not been committed to a mental facility against your will, you have absolutely every right to call your own shots regarding what medications you wish to ingest into your own body.

netsavy006
02-21-09, 01:16 PM
If I get her voice mail how is this:


"Hello Dr. X, this is Y, I followed your suggestion about reducing the Abilify to 5mg/day and I'm still getting restlessness and akathisia and I'd like to know if it is ok with you that I stop the Abilify. Please give me a call back @ 123-456-7890 so we can discuss this matter. Thanks. Have a good day. Bye".

Scarletta
02-21-09, 01:25 PM
That's very good. But I'd also add something like, "I'd like to stop as soon as possible because the effects are unbearable and causing me major anxiety."

Make it sound like it is IMPERATIVE she gets back to you right away- like it could be a very serious situation, which, in my mind, it is!

netsavy006
02-21-09, 01:36 PM
Boy, you are good Scarletta. I thank you for that tidbit, I'll be sure to mention that to my pdoc when I make the phone call. Now all that's got to happen is for Mom to approve that I can make the phone call come Monday morning. She might say yes, she might say no. I'm probably going to just make the call anyway regardless of her answer (like go behind her back) but the akathisia is a hard thing to live with, and is very uncomfortable. Thanks again, and I'll be sure to let you and the board knows what happens...

Scarletta
02-21-09, 01:42 PM
You're welcome and please do let me know!

netsavy006
02-21-09, 08:25 PM
Well I called a hotline number related to the mental health clinic I go to and I spoke to a pdoc that works there. He told me I could discontinue Abilify and just inform my regular pdoc via phone on Monday...

Scarletta
02-21-09, 08:29 PM
See, what did I say?? )

netsavy006
02-21-09, 08:35 PM
That's what you said. It could be removed, but I wanted approval from a doctor before I made the change. So now I have to call my regular pdoc on Monday. I gather in turn this may (or may not) mean an adjustment in my Zyprexa dosage. The highest I remember being able to go (w/o side effects) is 7.5mg.

The next step will now be getting off of the Artane because I don't get akathisia or restlessness on Zyprexa when under 10mg/day. But that's down the road as the Abilify clears from the system...

Scarletta
02-21-09, 09:01 PM
Isn't Artane a parkinson's drug? What are you on it for?

netsavy006
02-21-09, 09:03 PM
It was prescribed for the akathisia from the Abilify, but as we know it didn't work out that way and I was trying to explain to the doctor that it wasn't working but she was telling me that I was taking 2mg t.i.d., the highest I've ever been on. I don't get akathisia from Zyprexa when kept under 10mg/day so I know I'll be ok without it. But I know you can't just discontinue a medicaton. You have to be weaned off of it.

KFC in CA
02-21-09, 09:13 PM
Try taking some benadryl, 2-3 times regular dose. Just make sure it doesn't have a bunch of cold/cough stuff in it that you don't need. Generic's cheaper. This can help with akathesia.

Scarletta
02-21-09, 09:17 PM
I suppose that makes sense. I understand you won't need the Artane to counteract the extrapyramidal symptoms of Abilify since you won't be taking it, but how about the Zyprexa? In my medical books it lists parkinsonism, akathisia, shaking, speech impediment, abnormal gait as side effects. Would you need Artane for that?

You said you don't get akathisia from Zyprexa Zydis (what is the Zydis form anyway?) but do you get no side effects at all from it (besides the weight gain)?

Scarletta
02-21-09, 09:19 PM
KFC, if you've never had the type of akathisia that comes from Abilify, you are so lucky. It is miserable and no over the counter antihistamine helps it. Also as you can see the Artane wasn't even helping it, which is a rather strong drug.

For me nothing at all worked other than drastically reducing my dose, but then I went off it.

KFC in CA
02-21-09, 09:31 PM
I had horrible akathesia on just 1mg of Abilify. Will never touch the stuff! I was on 10mg of Zyprexa w/o problem and 160mg of Geodon, too. Seroquel over 150mg gets problematic.

I just suggested benedryl because mega doses are what's used in the hospital to treat akathesia. Adding some on top of the Artane could help a little. If even a little, it also adds a little sense of control.

netsavy006
02-22-09, 02:40 PM
I understand you won't need the Artane to counteract the extrapyramidal symptoms of Abilify since you won't be taking it, but how about the Zyprexa? In my medical books it lists parkinsonism, akathisia, shaking, speech impediment, abnormal gait as side effects. Would you need Artane for that?

You said you don't get akathisia from Zyprexa Zydis (what is the Zydis form anyway?) but do you get no side effects at all from it (besides the weight gain)?

I don't get the extrapyramidal symptoms from Zyprexa at all when I take under 10mg/day. This is how I know I won't need Cogentin or Artane when I take Zyprexa if we keep the dose low. Zyprexa Zydis is a melt in the mouth version of Zyprexa. It's a form of a tablet you place on the tounge and it disolves from the saliva right in your mouth/tounge. It's very fast desolving. I like it better because there's less sedation and it's clamed to have less weight gain.

Here's a link to more information about Zyprexa Zydis:
http://zyprexa.com/hcp/formulationsanddosing/zyprexazydis.jsp

It's written for health professionals so I appoligize if you don't understand all the information presented.

netsavy006
02-23-09, 04:46 PM
I had horrible akathesia on just 1mg of Abilify...

I was the same way. In fact, it's been 2 days since I've had a dose of Abilify and I'm still akathisic. I'm suppose to get a call from my doctor but she hasn't called back yet. It's in regard to the discontinuation of the Abilify.

netsavy006
02-23-09, 06:27 PM
Well to update, I got the call from her and I have an appt to see her tomorrow @ 1:40 to discuss my treatment options. I hope everything goes smoothly.

Scarletta
02-24-09, 02:59 PM
Well let me know what she said!

netsavy006
02-24-09, 03:32 PM
See it in this thread:
http://www.addforums.com/forums/showthread.php?t=64232

caccy46
03-23-10, 07:56 AM
I was given Abilify to augment my SSRI (Lexapro) for depression/OCD.
It was like a miracle drug at only 5 mg., but I soon began to experience akathisia and consequently had to come off after titrating down to 2 mg. and it did not relieve it.
Since then, I have been given 3 other anti-psychotics to augment the SSRI, but none relieved the severe depression.

Finally, my doc put me back on Abilify and added other meds to offset the akathisia, and it's worked. They are Propanolol (3 x daily), Amantadine (100mg 3x daily) and another substance Cerefolin (some sort of vitamin, I believe). The only problem I'm experiencing so far is difficulty staying asleep throughout the night. It's a lot of meds, but it's well worth it!